Opportunities and Challenges in Conducting Community-Based Participatory Research (CBPR) on Maternal-Child Health Disparities

Over 5 years, we have conducted CBPR on maternal and child health disparities, stimulated by NIH's request for planning grants and creation of a multi-site network. Partners in our DC site include the major maternity hospital, the only nurse-midwife Birth Center, and a leading university research center. In the Planning Phase we encountered problems caused by NIH's need to finalize a common study protocol prior to the local partnerships and national network developing adequately. Our local site adapted by conducting small-scale research projects that (1) respected the dual needs of community and university; (2) generated other grants to pursue promising ideas locally endorsed; and (3) led to tangible products (journal articles, scientific and clinical presentations, joint training of professionals, improved clinical protocols). Our CBPR has yielded new data-supported insights, such as role of untreated maternal depression in missed appointments, clinical withdrawal, non-optimal inter-pregnancy intervals; unrecognized inconsistencies in clinical recordkeeping; inadequacies in many formulations about health disparities (too simplistic; overlooking important co-morbidities; blaming in ways not well-suited to practical solutions; insufficient in seeing harmful effects of fragmented, competitive service provision). Our partnership seeks to share “lessons learned” and expand the CBPR paradigm in ways that directly address some of the predictable threats to success. We participate fully in the now-launched national 5-site study, using it as an opportunity to strengthen our local partnership while also collecting required data. CBPR sustainability depends upon open communication, frequent accommodations, and evidence of mutual benefits.

Learning Objective: Articulate 3 key factors in successful CBPR programs.